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Attention Deficit Hyperactivity Disorder

Any Studies On Long Term Effects of Ritalin?

02/20/2001

Question:

Are there any long-term studies on the effects of Ritalin specifically targeting African-American (AA) males? Perhaps one-third of the AA males` guardians with whom I work refuse psychostimulants in general and more specifically, Ritalin. Thereseems to be a "street" belief that Ritalin has a negative impact on AA males.

Answer:

There are no long-term prospective studies on any of the psychostimulants, such as Ritalin (a brand of methylphenidate). The NIH-funded studies begun during the last decade have some very good prospective information from about 6 years now. I will find out about some of the unpublished information and see if anything has come up other than percentages of children who are African-American and taking psychostimulants, but I am not aware of any. My personal, experience-guided sense (not the best way to make decisions, but all I have at the moment) is that these medications have far too often been used 1)to quiet down unruly children in large classrooms, 2)without any hands-on care, and 3)without careful adjustment so that some children end up with zombie-like affects and/or rage rebound reactions at the end of the day. I periodically have to spend time carefully explaining to patients and there families how neither I nor any of the experts at The Affinity Center, here in Cincinnati, would allow such care of our patients---let alone endorse it. All this is to say that I too would be wary of these drugs if I had only seen some of the misuse I hear about from patients` past experiences and if I did not know such things were not necessary to good therapy.

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Response by:

Susan Louisa Montauk, MD
Formerly Professor of Family Medicine
University of Cincinnati